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Callahan, Michael

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Callahan

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Michael

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Callahan, Michael
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    Quality of Pediatric Abdominal CT Scans Performed at a Dedicated Children’s Hospital and Its Referring Institutions: A Multifactorial Evaluation
    (Springer Science and Business Media LLC, 2017-01-13) Snow, Aisling; Milliren, Carly E.; Graham, Dionne; Callahan, Michael; MacDougall, Robert D.; Robertson, Richard; Taylor, George
    Background Pediatric patients requiring transfer to a dedicated children’s hospital from an outside institution may undergo CT imaging as part of their evaluation. Whether this imaging is performed prior to or after transfer has been shown to impact the radiation dose imparted to the patient. Other quality variables could also be affected by the pediatric experience and expertise of the scanning institution. Objective To identify differences in quality between abdominal CT scans and reports performed at a dedicated children’s hospital, and those performed at referring institutions. Materials and methods Fifty consecutive pediatric abdominal CT scans performed at outside institutions were matched (for age, gender and indication) with 50 CT scans performed at a dedicated freestanding children’s hospital. We analyzed the scans for technical parameters, report findings, correlation with final clinical diagnosis, and clinical utility. Technical evaluation included use of intravenous and oral contrast agents, anatomical coverage, number of scan phases and size-specific dose estimate (SSDE) for each scan. Outside institution scans were re-reported when the child was admitted to the children’s hospital; they were also re-interpreted for this study by children’s hospital radiologists who were provided with only the referral information given in the outside institution’s report. Anonymized original outside institutional reports and children’s hospital admission re-reports were analyzed by two emergency medicine physicians for ease of understanding, degree to which the clinical question was answered, and level of confidence in the report. Results Mean SSDE was lower (8.68) for children’s hospital scans, as compared to outside institution scans (13.29, P = 0.03). Concordance with final clinical diagnosis was significantly lower for original outside institution reports (38/48, 79%) than for both the admission and study children’s hospital reports (48/50, 96%; P = 0.005). Children’s hospital admission reports were rated higher than outside institution reports for completeness, ease of understanding, answering of clinical question, and level of confidence of the report (P < 0.001). Conclusion Pediatric abdominal CT scans performed and interpreted at a dedicated children’s hospital are associated with higher technical quality, lower radiation dose and a more clinically useful report than those performed at referring institutions.
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    How we read pediatric PET/CT: indications and strategies for image acquisition, interpretation and reporting
    (BioMed Central, 2017) Colleran, Gabrielle C.; Kwatra, Neha; Oberg, Leah; Grant, Frederick; Drubach, Laura; Callahan, Michael; MacDougall, Robert D.; Fahey, Frederic; Voss, Stephan
    PET/CT plays an important role in the diagnosis, staging and management of many pediatric malignancies. The techniques for performing PET/CT examinations in children have evolved, with increasing attention focused on reducing patient exposure to ionizing radiation dose whenever possible and minimizing scan duration and sedation times, with a goal toward optimizing the overall patient experience. This review outlines our approach to performing PET/CT, including a discussion of the indications for a PET/CT exam, approaches for optimizing the exam protocol, and a review of different approaches for acquiring the CT portion of the PET/CT exam. Strategies for PACS integration, image display, interpretation and reporting are also provided. Most practices will develop a strategy for performing PET/CT that best meets their respective needs. The purpose of this article is to provide a comprehensive overview for radiologists who are new to pediatric PET/CT, and also to provide experienced PET/CT practitioners with an update on state-of-the art CT techniques that we have incorporated into our protocols and that have enabled us to make considerable improvements to our PET/CT practice.